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ACC/SCN Working Group on Nutrition in Emergencies

Excerpts from Working Group Report

The ACC/SCN held its 27th Session at the World Bank in Washington DC last April. About 60 participants from NGOs, bilateral and UN agency were present for the afternoon meeting of the Working Group in Emergencies. The agenda included, among other topics, an update on research work among malnourished adults and nutritional problems faced by infants in emergencies.

Update on Adult Malnutrition programmes and research in Brazzaville and Burundi

(Carlos Navarro, ACF-F Action Contre La Faim)

Dr. Navarro presented a broad overview of some of the problems encountered when trying to treat severely malnourished adults in Burundi and Congo-Brazzaville, where ACF is undertaking an analysis of its operational (nutritional) programmes. The project in Burundi has been operating since 1994 and at least 1,000 persons per month (including 700 adults) have been treated in 5 Therapeutic Feeding Centres (TFCs) in two provinces. The programme in Brazzaville began in July 1999, and has treated approximately 600 patients per month, including 400 adults, in 3 TFCs. The objective of the presentation was to present some of the operational dilemmas that arise.

Emergency nutrition interventions aiming to address adult malnutrition, are becoming increasingly common practice in emergencies and there continues to be an enormous demand for information on diagnostic criteria, and protocol specifications.

In summary, the following issues were highlighted as operational problems in ACF programmes:

Criteria for assessment of acute adult malnutrition

Medical management of patients in TFCs
The high prevalence of both acute and chronic disease among malnourished adults poses a serious challenge in the management of adult malnutrition. The design of therapeutic feeding for adults must take into consideration some important medical issues. These include:

An agency that wants to assist severely malnourished adults may therefore need to consider a complete revision of the strategy, objectives, training, and other means (including human) it usually puts in place to cope with severe malnutrition in emergencies.

Oedema and refeeding oedema

Treatment considerations


Social considerations

Nutritional problems faced by infants in emergencies

Prof. Michael Golden, University of Aberdeen

Prof. Golden outlined a number of important problems/issues regarding infant nutrition. Issues about the inclusion of infants in nutritional surveys were covered in an article post-script written by Prof Golden in Field Exchange 9* and so will only be cursorily dealt with here. The main points about infants in nutritional surveys made in the presentation were that:

Additional points raised by Golden about infant nutrition in emergencies included the following:

Mother's diet

Recommendations of the Working Group to the ACC/SCN for action

Adult malnutrition

Clarify issues relating to adult malnutrition including its definition, and operational intervention guidelines. Disseminate this information as widely as possible to agencies in need of support and guidance.

Infant feeding issues

Liaise with the Breastfeeding and Complementary Feeding Working Group in taking responsibility for further development of the operational guidance, management of the consultative process and coordination of dissemination. Improve the training of humanitarian staff on infant feeding practice. Advocate for the need of experts on infant feeding issues to be present at all emergencies from the outset.

For further information or full report contact the ACC/SCN c/o World Health Organisation, 20 Avenue Appia 1211 Geneva 27 Switzerland. phone: + 41-22-791 04 56 fax: + 41-22-798 88 91 EMail:

Show footnotes

*'Comment on: Including infants in nutrition surveys, experiences in Kabul city', Field Exchange 9, March 2000, pp16-17

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Reference this page

ACC/SCN Working Group on Nutrition in Emergencies. Field Exchange 10, July 2000. p9.